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NPI Code Detail

MEDICARE: LYNNETTE RAIMONDO

MEDICARE: LYNNETTE RAIMONDO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistS020382AZ

General Provider Information

NPI Number : 1871907402
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNNETTE RAIMONDO
Provider Business Mailing Address
First Line : 3130 W CAREFREE HWY
Second Line :
City : PHOENIX
State : AZ
Zip : 85086-3200
Country : US
Telephone Number : 623-582-5743
Fax Number : 623-582-8074
Provider Business Practice Location Address
First Line : 3130 W CAREFREE HWY
Second Line :
City : PHOENIX
State : AZ
Zip : 85086-3200
Country : US
Telephone Number : 623-582-5743
Fax Number : 623-582-8074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2014
Last Update Date : 06/11/2014

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Directions to “ LYNNETTE RAIMONDO ” Practice Location

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